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Medical?...MRSA and what you find out...

Discussion in 'General Discussion' started by dragonfly, Jul 14, 2011.

  1. dragonfly

    dragonfly Monkey+++

    My 21 year old son recently ( July 1st) had a "boil" as it appeared on the back of his right leg, halfway from his buttocks and his knee...
    He came to me on the second day, saying it had opened and drained a bit but was really bigger now and quite sore.
    I proceeded to clean it as you would most types of boils, using hot compress' to open the pores and to help drain it.
    I washed the area with hydrogen peroxide and then cleansed it more with Betadine solution. The next day it was out of control...
    It took me another day to convince him it was something I could not get a handle on and he neded to be seen by a doctor immediately.
    On the 5th we went to the ER.
    It was apparent to the staff immediately it was now a severe staph infection.....We had to find out what kind.....
    They took him to a room and I sat and watched ( talking with doctor and nurse) as they incised the area with a 1 inch "+" incision and proceeded to clean the whole thing...( NO, I don't like to watch, but I need to know what is happening and why) Glad I did too!
    They told him he would need to stay at least overnight in the hospital so they could get the blood tests back to see exactly what they were dealing with...At first it looked like a boil or really nasty pimple....then it begn to take on the appearance of a spider bite ( necrosis of the area).
    The area became hugely swollen and red, with massive lumps in a circle around now what was about 5 inches in diameter....It was growing.
    ( I'm talking UGLY!)
    So, on the 3rd day of his hospital stay, he had a second and much larger more invasive surgery. Now the incision was 4 inches north to south and 4 inches east to west in a cross shape. He was put to sleep for that one and I found out after the fact, 5 hours after the fact, as he was still knocked out!
    The next day the doctor came in and discharged him... (HUH? with MRSA?)
    (they don't NEED any more of it in the hospital , as they already have a suffcient supply, or so I was told!)
    However, the doctor had specifically left instructions on having a nurse show me how to clean, repack, and re-bandage the leg.....
    No one could be bothered evidently....At least not 2 of the staff nurses!
    He was discharged and I had no instruction at all on how to care for a open wound that size and we were told just before he was rolled out the door, that it was confirmed he had MRSA.
    Now that stuff is not only highly contagious and infectious, it is NOT something an amateur messes with!
    Me, well.... I am less than an amateur in the medical sense....Trust me!
    However, the staff did put together a "gift bag" with several medical items to care for the wound...and I quickly surveyed the situation and "secured" ( nice word that one huh?) more.....A LOT MORE!
    Suffice it to say, that I did NOT leave there empty handed in any case.
    So, we get home and I knew the dressing had to be changed inside of 2 days at the outside....
    Imagine me, trying to get the nerve and stamina to remove those bandages and take on something I had never done, was not well versed in and had little stomach for....
    I mean it's NOT the blood mind you, but I am a tad bit queasy when it's my own son and the size of that incision was not something I relished seeing.
    I prepped the sofa so he could lie face down, with a plastic barrier covering 2 of the 3 sofa cushions, then a new white towel on top of the plastic that had been sterilized by washing then boiling for 5 minutes then dried in the sun...
    I was more nervous than a cat on a hot tin roof with pit bulls below me!
    No...Seriously, I was scared half to death! I Still am even today...
    But, I cut away the gauze wrapping and then began to gently and slowly lift off the 2 x 2 gauze pads. I had to use the .9% saline irrigation solution in the syringes ( about 20 cc size) to soften and loosen the last 3-4 gauze pads as they had stuck to his open wound. ( no details ok?)
    I managed to get them all off and then trying not to lose it, I had to flush/irrigate the area inside and wipe any drainage away from the outside area with special anti-bacterial wipes.
    Once I had removed the gauze and I found a large "blob" of what appeared to be a "clot", it began to bleed, not severly, not badly, but it was a capillary that had been cut, and it was not going to stop on it's own accord. Oh boy...now I am worried!
    When I had got home I unpacked the bag they had provided and inside I had seen a small package with the words: NU Knit, hemostatic bandage, sterile.
    I opened it ( when it was time to do so) and found what appeared to be a 2 x 2 of some fabric, that was coarse and looked for all intents and purposes as fiberglass cloth! Weird stuff, but boy am I glad I had it!
    After cleaning the wound area ( very carefully and GENTLY) I inserted the 2 x 2 cloth and then placed 2 pads of "aquacel" another anti-bacterial material that looks kind of like gray flannel, and says Ag on it.....
    Now I know Ag means silver, ahah! A revelation! I am on to something now! I criss crossed them over the wound area, then placed about an inch and a half of 4 x 4 gauze pads on top, alternating them. I then wrapped the whole thing with the Kerlix gauze roll, and following what I had seen before removing the original bandages, I tucked the corner in, not using any adhesive tape at all. My son was exhausted and I felt like I had just fell off the side of a mountain...or a roller coaster...stress is a real bugger!
    I was sick as a dog to my stomach and just kept on keepin' on.
    But I am not out of the woods, not just yet.
    I got on the internet and quickly researched ( took me 4 hours!) on the medical components I had just used and how I had applied them.
    I read ALL of the pdf files for surgeons and reccomendations of each manufacturer.
    After that, I felt as if a ton of weight had been lifted off my shoulders..
    I managed to do it right the first time and in the correct sequence.
    ( don't try this at home!)
    My sincerest advice: read all you can before you begin ( when possible of course!) and then you'll be more confident and a lot less stressful when treating any such scenario. And your stomach will be happier too!

    My son went to the doctors office this afternoon for his first followup visit.
    The doctor asked me who had done the repacking and re-bandaging of his wound....( I figured I'd really screwed something up!) Not something you want to know, and how bad that sort of screw up can be...( fatal in some instances)...The doctor had me stand there as he unwrapped the dressing and he explained what I had done, was exactly what he does, but now....the wound was 1/2 the size it was only 3 days earlier, clean, no infection, no redness, no swelling at all...just the open incision area.
    He asked what I did, how I'd done it and why I did the dressing the way I did....All I could say was that it seemed to be the right way to dress the wound. I had no excuses at all!
    (I had placed a dissolving and blood clotting agent in the right area where the capillary had been damaged ( Nu Knit) and then covered it with the (Aquacel) bandages that contained 1.2 % ionic silver, that absorbs only the bad guys and keeps the wound moist and bacteria free, while turning into a gel. Then covering it with a heavy gauze padding and wrapping it loosely to hold it all in place.)
    The wound is such today that all that was needed was to cover the area wih gauze and re-wrap it. Friday, the doctor says it may be closed enough to just keep it loosely covered, and may heal in a week or less!
    Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a strain of staph bacteria that's become resistant to the antibiotics commonly used to treat ordinary staph infections.

    A type of MRSA infection has occurred in the wider community — among healthy people. This form, community-associated MRSA (CA-MRSA), often begins as a painful skin boil. It's spread by skin-to-skin contact. At-risk populations include groups such as high school wrestlers, child care workers and people who live in crowded conditions.

    Staph skin infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin. But they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.
    In any case, wash your hands! If you have it, or are a caretaker for someone else with it, wash and sterilize their bedding and clothing.
    I took precautions and wore surgical gloves when handling any part of the bandages or the wound area and the sterile field I had used. Everything was double bagged in plastic bags and disposed of immediately.
    The antibiotic drug prescribed was Cipro or Ciproflaxin.
    So far, it's working wonders.
    I'd rather be a Taxi Driver!
    LogOut and chelloveck like this.
  2. tacmotusn

    tacmotusn Mosquito Sailor

    Kudos my Man! I could not do what you have done. I have no other words. Your experience both amazes me and scares me stupid.
  3. -06

    -06 Monkey+++

    That stuff is vicious and has to be taken care of very quickly. Seems you did a bang up job of taking care of your son. Congrats.
  4. chelloveck

    chelloveck Diabolus Causidicus

    Cheers to nurse dragonfly

    Your son is lucky to have the father that he has....and although the circumstances that you both found yourselves in were not what either of you would have wished....you have the benefit of knowing that you have learned sufficient from the experience that you can effectively carry out the wound management necessary to deal with helping someone to recover from serious wound trauma.

    It is a cautionary tale to us all, that wound hygiene is extremely important, particularly as there are fewer antibiotics available effective against all types of bacterial infections. It will get to the point, unless new bio-medical research bring new antibiotics on line, that mortality and morbidity risks will revert to something similar to what they were in the days before WWII.
  5. CATO

    CATO Monkey+++

    Man....that's scary. I'm glad it turned out well...MRSA is not something to play around with, and usually not something that has such a good outcome.

    Some background info:

    hospitals make the distinction when dealing with bugs such as this by categorizing them as "community acquired" or "hospital acquired." Most states require hospitals to report only hospital acquired infections (HAIs) to the CDC via the National Heatlhcare Safety Network (NHSN). Generally, each hospital has an "infection control preventionist" (ICP) who keeps track of all of this. It doesn't surprise me that they basically kicked you out. But, on the bright side, you're probably less likely to get any new infections at home as compared with all of the bugs you could get in a hospital.

    Right now, on everyone's skin, you have "common skin contaminants" (CSCs). One of these CSCs is staphylococcus aureus. Right now, you can think that there are two kinds, normal staph and methicillin-resistant. The last is deemed an MDRO (multi-drug resistant organism). So, you have these on your skin...don't freak out; your skin is very good at protecting you...unless you have a wound.... I'm guessing your son had some type of insect/arachnid bite and that was the channel that MRSA invaded his skin. The "boil" was just his body trying to fight it off.

    One thing you should be concerned with now is c.diff (clostridium difficile). Generally, the people who get c.diff have had a round of antibiotics in their past. I would give the house a good cleaning, especially the bathrooms.

    Again, I'm really glad this had a happy ending...and you got some good skills out of it too!
  6. wags_01

    wags_01 Monkey+

    LogOut likes this.
  7. Tracy

    Tracy Insatiably Curious Moderator Founding Member

    Keep your eye on it throughout the entire healing process! We just went through a bought of that not too long ago (I was the one who got to play nurse). We had to go so far as to having to have the IV antibiotic treatment. Lucky for us - we could do it at home, so I didn't have to make daily runs to the hospital. :)

    I hope he's healing quickly!
  8. Witch Doctor 01

    Witch Doctor 01 Mojo Maker

    Still using the Iv treatment for my Father in Law... following crainal surgery... it's a real pain
  9. LogOut

    LogOut Monkey+

    Amazing what a parent can do for a child when necessary isn't it ?

    Sounds like you had a guardian angel (or just the voices in your head) guiding you

    Glad there is a happy ending to this story, and thanks for posting/sharing.
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